PURPOSE: The aim of this study was to compare survival of patients with uterine sarcomas using the 1988 and 2008 International Federation of Gynecologists and Obstetricians (FIGO) staging systems to determine if revised 2008 staging accurately predicts patient survival. MATERIALS AND METHODS: A total of 83 patients with leiomyosarcoma and endometrial stromal sarcoma treated at Yonsei University Health System between March of 1989 and November of 2009 were reviewed. The prognostic validity of both FIGO staging systems, as well as other factors was analyzed. RESULTS: Leiomyosarcoma and endometrial stromal sarcoma comprised 47.0% and 53.0% of this study population, respectively. Using the new staging system, 43 (67.2%) of 64 eligible patients were reclassified. Among those 64 patients, 45 (70.3%) patients with limited uterine corpus involvement were divided into stage IA (n=14) and IB (n=31). Univariate analysis demonstrated a significant difference between stages I and II and the other stages in both staging systems (p<0.001) with respect to progression-free survival and overall survival (OS). Age, menopausal status, tumor size, and cell type were significantly associated with OS (p=0.011, p=0.031, p=0.044, p=0.009, respectively). In multivariate analysis, revised FIGO stage greater than III was an independent poor prognostic factor with a hazard ratio of 9.06 [95% confidence interval (CI) 2.49-33.0, p=0.001]. CONCLUSION: The 2008 FIGO staging system is more valid than the previous FIGO staging system for uterine sarcomas with respect to its ability to distinguish early-stage patients from advanced-stage patients.
Adult ; Disease-Free Survival ; Female ; Humans ; Leiomyosarcoma/mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Uterine Neoplasms/*mortality/*pathology

OBJECTIVETo investigate whether the border-line uterine smooth-muscle tumor is different from leiomyoma or leiomyosarcoma in history and clinical manifestations.

METHODSThe medical records of 131 surgically treated patients suffering from the so-called cellular leiomyoma or mitotically active leiomyoma of the uterus treated from 1984 to 2002 were retrospectively reviewed. All pathological sections of these patients were reviewed by a senior pathologist. Chi-square test and Kaplan-Meier life table were used for statistical analysis.

RESULTSThe overall 5-year survival rate of patients with the border-line uterine smooth-muscle tumors was 100%, however, 19.1% (24/131) of whom developed a late recurrence and 8 patients had repeated recurrences with a more shortened course and aggressive potential changes of mitosis and cellular atypia. The overall 5-year survival rate the patients with recurrence was 91.7%, but only 75.0% for those with repeated recurrences.

CONCLUSIONPatients with border-line uterine smooth-muscle tumor do possess some difference in nature from the leiomyoma or leimyosarcoma. Long-term follow-up is very important for these patients after surgery.

Adult ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; pathology ; surgery ; Leiomyosarcoma ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Smooth Muscle Tumor ; mortality ; pathology ; surgery ; Survival Rate ; Uterine Neoplasms ; mortality ; pathology ; surgery

PURPOSE: Recently, the importance of early diagnosis and early treatment has been increasing, and there are many cases where tumors have been discovered incidentally. However, due to lack of reports regarding pancreatic cases, the clear management plan remains in dispute. This study attempted to analyse pancreatic cases so as to offer a management direction. METHODS: From October 1994 to May 1999, we experienced 28 cases of incidentally discovered pancreatic tumors and those cases were reviewed retrospectively. RESULTS: In regards to initial referrals for diagnosis, 19 cases were from general medical examinations, and 9 cases were referred due to symptoms or signs not related to their tumors (2 cases with hepatitis B, 2 cases with lung lesions, 1 case with a gastric leiomyosarcoma, 1 case with vaginal bleeding, 1 case with acute enteritis, 1 case with a toothache and 1 case with a headache). Twenty cases were initially detected from abdominal US, 3 cases from abdominal CT, 2 case from chest CT, 2 case from the simple abdomen, and 1 case from CA 19-9 investigation. The accuracies for diagnosing the precise type of tumor were CT 42.3% (11/26), ERCP 15.3% (2/13), abdominal US 12.5%, and (3/24). Postoperative pathologies included 7 serous cystadenomas, 6 solid-pseudopapillary tumors, 4 mucinous cystic neoplasms, 4 nonfunctioning islet cell tumors, 2 intraductal papillary mucinous neoplasms, 2 simple cysts, 1 ductal adenocarcinoma, 1 benign retension cyst, and 1 pseudocyst. Among these were 5 malignant neoplasms (3 nonfunctional islet cell tumors, 1 ductal adenocarcinoma, and 1 mucinous cystic neoplasm), and 17 cases (60.7%) were premalignant tumors. All cases were treated with a pancreatic resection, and postoperative follow-up was carried out for a period of 3-66 months. During thisperiod, no recurrence or mortality was noted other than 1 case of liver metastasis 12 months postoperatively for ductal adenocarcinoma. CONCLUSION: Although presence of a ductal adenocarcinoma is rare in incidentally discovered pancreatic tumors pancreatic incidentaloma is common in premalignant neoplasms. Therefore, even in asymptomatic cases, aggressive surgical resection is necessary for accurate diagnosis and early treatment.
Abdomen ; Adenocarcinoma ; Adenoma, Islet Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Cystadenoma, Serous ; Diagnosis ; Dissent and Disputes ; Early Diagnosis ; Enteritis ; Follow-Up Studies ; Hepatitis B ; Leiomyosarcoma ; Liver ; Lung ; Mass Screening* ; Mortality ; Mucins ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Pathology ; Recurrence ; Referral and Consultation ; Retrospective Studies ; Tomography, X-Ray Computed ; Toothache ; Uterine Hemorrhage